Objective: Attempt to use generalized graded unfolding model to analyze the item of "Autonomy in Learning Rating Scale for College Students " adequacy of the scale designing and evidence probability of the usage of unfolding model in costructing tests. Methods: Based on randomly selected 600 graduates’ response of the scale, item analysis was carried on in 497 potent subjects. Results: Subjects whose trait continuum were between 2.5-4.0 and -3.5～-3.0 were short, and all the item locations were negative; all the item discriminations were above 0.5; the item information functions of 2, 6, 7, 19, 21, 25, 49, 50, 51 were below 0.4098; the fit plots of the item and test satisfied the requirements. Conclu- sion: Fit index of the whole scale is good; some items need to be revised or deleted; GGUM could be used in constructing attitude scales.

Objective To improve the efficienct of bone defect reparing,we produced a new shaped bone substitude.And we study the result from repairing rabbit radial segmental defect.Method Twenty mature rabbits were made segmental radial defect on both sides.15 received allogenic bone powder/FS/BMP in the left,and allogenic bone powder/FS in the right.5 samples received no implant in the left as control and allogenic bone powder/FS in the right.4,8,12 weeks after operation,result were assessed by gross,radiographic and histologcal examination.Result the study showed that allgonic bone powder/FS/BMP was much faster and better than allogenic bone powder/FS in repairing the defect(P<0.05),Conclusion It is suggest that allogenic bone power/fs/BMP is a kind of high bone induce ability ,shaped,and absorbable bone substitute.

Objective To investigate the protective effect of short-term moderate exercise on ischemic/reperfused myocardium and its correlation to the activation of protein kinase C(PKC).Methods Fourty Wistar rats were randomly divided into 4 groups(n=10 respectively): control group(CON group),exercise group(EXE group),exercise + PKC inhibitor group(E+C group) and PKC inhibitor group(CHE group).The occurrence of arrhythmia,the recovery of cardiac function,and infarct size were observed by using the Langendorff-ischemia/reperfusion model in isolated rat heart in vitro.Results Recovery rate of LVDP(on the 30th and 60th minute of reperfusion) and RPP(on the 20th,30th and 60 minute of reperfusion) of EXE group were higher than those of CON and E+C groups(P

Abstract: Objective To explore the clinical data of children with Talaromyces marneffei (TM) infection admitted to the pediatric intensive care unit (PICU) to improve the diagnosis and treatment of TM infection in children. Methods The clinical data of 23 children with TM infection treated in four PICUs in southern China from January 2013 to December 2022 were retrospectively analyzed, including clinical characteristics, laboratory tests, treatment regimens, and outcomes. Results Among the 23 children, there were 14 boys and 9 girls, with a median age of 24 months. The time from onset to admission was 15 (range 10-30) days, and one patient had immunodeficiency disease. Common symptoms included fever (91.3%, 21 cases), cough (78.3%, 18 cases), and hepatosplenomegaly (78.3%, 18 cases). Severe clinical complications included multiorgan dysfunction (69.6%, 16 cases), septic shock (65.2%, 15 cases), and acute respiratory distress syndrome (65.2%, 15 cases). All patients elevated CRP levels, and 69.2% (9/13) had a positive G test. Elevated IgE levels were observed in 53.3% (8/15) cases, CD4/CD8 inversion in 17.6% (3/17) cases, and reduced NK cells in 84.2% (16/19) cases. HIV tests were negative in all cases. TM was most frequently detected by blood and bone marrow cultures. Seven cases were diagnosed with immunodeficiency by genetic testing. With monotherapy or combination of amphotericin B or/and voriconazole, followed by oral medication, 13 (56.5%) children died. Conclusions TM infection is clinically atypical in HIV-negative children, and patients admitted to PICU have rapidly deteriorated, with severe complications and a high mortality rate. Early use of multiple samples, and multiple methods to detect TM, combined with immune function and genetic test, is helpful to early diagnosis. The antifungal treatment strategies still need further study.

Objective To investigate the clinical therapeutic effect of acupuncture on pulmonary infection after acute cerebral infarction.Methods Seventy patients with pulmonary infection after acute cerebral infarction were randomly allocated to treatment and control groups, 35 cases each. The control group received routine medication and the treatment group, acupuncture in addition. Pre-treatment and post-treatment National Institutes of Health Stroke Scale (NIHSS) scores and clinical pulmonary infection scores (CPIS) were compared between the two groups. The correlation between the NIHSS score and the CPIS score was observed.Results There were statistically significant pre-/post-treatment differences in the NIHSS score and the CPIS score in the two groups (P<0.05,P<0.01). There were statistically significant post-treatment differences in the NIHSS score and the CPIS score between the treatment and control groups (P<0.05). The correlation between the NIHSS score and the CPIS score was low in the treatment group after treatment (r=0.417,P<0.05).Conclusions Acupuncture plus medication is an effective way to treat pulmonary infection after acute cerebral infarction. It can improve the NIHSS score and the CPIS score in the patients.

Objective To observe the effects of laparoscopy combined with choledochoscopy in the treatment of polypoid lesions of gallbladder and the effects on postoperative rehabilitation of patients. Methods 78 cases of patients with polypoid lesions of gallbladder treated in our hospital from August 2011 to November 2014 were selected as the study object. According to the order of medical treatment and hospital admission , the patients were numbered and randomly divided into laparoscopy group and combined group , with 39 cases in each group. The laparoscopy group were treated by laparoscopic cholecystectomy while the combined group were treated by laparoscopy combined with choledochoscopy gallbladder-protection surgery. The operation indicators , recovery of gastrointestinal function and incidence of postoperative complications in the two groups were observed. After discharge , the 2 groups of patients were followed up for 1 year. The improvement of postoperative digestive tract symptoms and rehabilitation of patients was observed. Results The intraoperative bleeding volume, postoperative fasting time, defecation time and hospitalization time of the combined group [(20.13 ± 7.48) mL, (0.51 ± 0.98) d, (1.20 ± 0.84) d, (1.98 ± 1.54)d] were less than those of the laparoscopy group (P <0.05); The incidence rate of complications in the combined group (10.26%) was lower than that in the laparoscopy group (33.33%) (P < 0.05); Immediately at the end of operation and 1 week after operation, VAS scores of the combined group [(4.23 ± 0.41), (2.46 ± 0.17) ] were lower than those in the laparoscopy group (P < 0.05); At the last follow-up, KPS score of the combined group increased to (89.98 ± 1.24), which was higher than that in the laparoscopy group (P < 0.05); GradeⅠpostoperative recovery in the combined group accounted for 87.18% which was higher than that in the laparoscopy group (64.10%). There was no case of grade III and the proportion was lower than that in the laparoscopy group (15.38%). The differences in proportions of grade I and III between the two groups were statistically significant (P < 0.05). Conclusion To adopt laparoscopy combined with choledochoscopy in the treatment of polypoid lesions of gallbladder , the curative effect is certain and the minimally invasive advantage is obvious. The long-term recovery effect is good and the safety is high.

ObjectiveTo explore the practicability and security of the ultracision harmonic scalpel in radical gastrectomy for patients with proximal gastric cancer.Methods115 patients of stage Ⅰ ～ Ⅲ proximal gastric cancer undergone radical gastrectomy were analyzed retrospectively.65 patients were performed with ultracision harmonic scalpel,the other 50 patients were performed with conventional operation.The operative time,volume of intraoperative hemorrhage,length of incision,and postoperative complications were analyzed.ResultsThere were significant difference in operative time ( 126.9 ± 20.7 ) min and ( 150.6 ± 31.7 ) min ( P ＜ 0.05 ),volume of intraoperative hemorrhage (105.7 ±40.3)ml and (171.7 ±63.2)ml(P＜0.01) and length of incision(17.2 ±2.1)cm and (20.3 ±2.3)cm (P ＜ 0.05 ).There was no significant difference in the postoperative complications between ultracisiou harmonic scalpel group and conventional group.All patients recovered without severe complications.ConclusionRadical resection of proximal gastric cancer using ultracision harmonic scalpel could shorten operative time,decrease intraoperative hemorrhage,shorten incision length,and the technique is convenient and safe.

Objective To compare the effect of two operative methods,median-rid-section and sub axillary median-rib-section.Methods 152 cases underwent by median-rib-section and among them 12 cases underwent by sub axillany median rib section.Results The median-rib-section procided a satisfact incision(the area of ineision was 14cm?30cm),without renobing the ribs,with the musculature.Complete,and less trauma.And the method of sub axillary median-rub-section had more intrathoracre esposure(the area of inclsion was 14cm?20cm),and the thoractomy could be done directly and satisfactory.Conclusion The median-rib section is a good method in thoraxoctomy which makes the ribs,made less trauma and provides satisfactory exposure,and after surgery,the chest is closed tighly.The sub axillary media rib section provides a wider application while remaining the good charactery of common sub axillary section.

Objective To study the feasibility of reconstructing trachea by implanting autogenous costal perichondrium tracheal prosthesis.Methods Ten dogs were used.Three pieces of costal perichondrium of every dog were wrapped on a silicon bar used as skeleton and implanted into sternohyoid muscle adjacent to trachea to establish blood supply.Four weeks later,silicon bar was removed and perichondrium ring served as tracheal prosthesis.Trachea resection and prosthesis replacement was performed.Viability of dogs,gross and microscopic pathological changes were studied to evaluate the effect of prosthesis replacement.Results The respiratory tracts of the 8 survival dogs were not obstructed.Their diet,activity and bark were not different from those of the normal dogs.With abundant blood supply,the prosthesis fused tightly with the surrounding tissue.Anastomotic orifice healed without cicatricial tissue and granulation tissue.The internal surfaces of prosthesis were smooth and glossy with white tunica mucosa covered.Under light microscope,internal surfaces of prosthesis were found covered by pseudostratified columnar epithelium with few cilia.Under tracheal mucous membrane,there were fibrous membrane,neonate chondrocytes and striated muscle cells stratum successively.Fibrous membrane was composed of collagen and fibroblasts with a few inflammatory cells scattered.A small number of neonate chondrocytes were found under fiber membrane.Plasma of these chondrocytes looked pale after staining,which indicated that these chondrocytes were neonate.Striated muscle cells connected with the neonate chondrocytes firmly. Neonate capillaries and micro blood vessels of various diameters were abundant in striated muscle stratum.Conclusion It is feasible to reconstruct dog trachea using prosthesis constructed with autogenous costal perichondrium.

ObjectiveTo investigate the efficacy of superficial surround needling plus quadriceps femoris training in treating knee osteoarthritis and observe electromyographic amplitude variations by knee osteoarthritis.MethodNinety patients diagnosed with knee osteoarthritis were randomly allocated to treatment and control groups, 45 cases each. The treatment group received superficial surround needling plus quadriceps femoris training and the control group, acupuncture alone. Both groups were treated for two weeks. Pre-treatment and post-treatment knee joint functions were scored and compared using the Visual Analogue Scale (VAS), the Lysholm Knee Score Scale and the electromyographic integral value. Meanwhile, electromyography was performed and electromyographic amplitude variations by knee osteoarthritis were compared between the two groups of patients.ResultThe total efficacy rate was 88.9% in the treatment group and 60.0% in the control group. It was higher in the treatment group than in the control group (P<0.05). After treatment, the VAS score, the Lysholm score and the electromyographic integral value were significantly better in the treatment group than in the control group (P<0.05).ConclusionSuperficial surround needling plus quadriceps femoris training has a marked therapeutic effect on knee osteoarthritis.